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Background: Initiating treatment within the optimal time is critical for women with breast cancer. A delay in cancer treatment initiation can result in increased morbidity and mortality and decreased overall survival. Objective: This systematic review aims to investigate the literature for the factors and beliefs affecting women diagnosed with breast cancer with regard to initiating cancer treatment. Methods: The PubMed, CINAHL, and PsycINFO databases were searched using the terms of breast cancer, initiating or seeking treatment, and beliefs. The Johns Hopkins Evidence-Based Practice Research Evidence Appraisal Tool was used to evaluate the included articles. Results: Sixteen articles were included in this review. The addressed factors were classified as (1) patient-related factors, (2) disease-related factors, (3) provider-related factors, and (4) system-related factors. The identified beliefs were cultural beliefs and perceived barriers to initiating treatment. Conclusion: Although the literature reported multiple factors and beliefs that impact the time of initiating treatment among women with breast cancer, more research is needed to fully understand the beliefs influencing treatment initiation. It is essential to address and screen the factors and beliefs identified for women diagnosed with breast cancer to enhance treatment initiation early and prevent any possible delay. Interventions can be developed to overcome the factors and beliefs that may lead to late treatment initiation. Advocacy for new policies should be in action to reduce the disparities associated with treatment initiation among women with breast cancer. [ABSTRACT FROM AUTHOR]

Background: Midlife Black women suffer disproportionately from cardiovascular disease and are 65% more likely to die following a cardiac event compared with White women. Recruitment and retention of midlife Black women in clinical trials has been historically low. The culturally tailored Midlife Black Women's Stress Reduction and Wellness (B-SWELL) intervention was codeveloped with the community and designed to lower cardiovascular disease risk in midlife Black women. Objectives: We sought to assess participant satisfaction in the randomized feasibility trial of the B-SWELL intervention. Methods: A feasibility trial comparing the B-SWELL to a wellness intervention was conducted in the winter and spring of 2021 in compliance with pandemic research protocols. An adapted survey tool was used to rate satisfaction with the intervention and its technology using a Likert-type scale (1 [strongly disagree] to 5 [strongly agree]). Survey subscales assessed usefulness, ease, and acceptability of the intervention(s). Results: Randomization yielded no statistical demographic differences (N = 48). Satisfaction for the interventions was high in both the B-SWELL and Wellness intervention groups with mean scores of 4.57 and 4.56, respectively. Mean scores for technology were 4.49 for the B-SWELL and 4.47 for the Wellness group. Subscales were also rated highly. Narrative responses were positively aligned with satisfaction scores. Conclusions: Results support use of cultural adaptation and community participatory methods to develop and deliver interventions targeted to at-risk populations. Culturally adapted interventions designed in collaboration with the community have greater authenticity, increasing the potential for higher recruitment, retention, and participant satisfaction of underrepresented populations. The trial is registered in ClinicalTrials.gov (NCT 04404478). [ABSTRACT FROM AUTHOR]

Background: Exposure to chemotherapy is an occupational hazard predisposing nurses to severe health effects. The purpose of this integrative review was to identify the recent literature describing the risk factors for occupational exposure to chemotherapy among nurses. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was employed to conduct the review. The databases searched were Scopus, PubMed, and CINAHL using the search terms "chemotherapy," "drugs," "exposure," and "nurses." Included articles were published between January 2010 and February 2022, published in peer-reviewed journals for research conducted in the United States, and written in English language. Excluded articles were studies that did not involve nurses in their samples. Review articles, books, theses, and dissertations were excluded as well. The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess the level of evidence from the reviewed studies. Findings: Fourteen studies were included in this review. Ten studies were rated on Evidence Level III, two on Evidence Level II, one on Evidence Level I, and one on Evidence Level V. The main risk factors for occupational exposure were nurses' knowledge of chemotherapy handling guidelines, nurses' adherence to using the personal protective equipment, nurses' health beliefs regarding chemotherapy exposure, and workplace-related factors such as workload and managerial support. Conclusion: Addressing the identified risk factors would protect nurses from chemotherapy exposure. More research on nurses' health beliefs regarding chemotherapy exposure and the cues to adhere to chemotherapy handling guidelines in the work environment is needed. [ABSTRACT FROM AUTHOR]

This study reports the development and psychometric testing of the Kidney Transplant Self-Management Scale (KT-SMS). The instrument development phase included the following: (a) conceptual definition, item generation, and framework; (b) face validity assessment; and (c) content validity assessment. The psychometric testing phase included the following: (a) construct validity testing; (b) internal consistency reliability testing; (c) convergent validity testing; and (d) predictive power of the KT-SMS using a cross-sectional sample of kidney transplant recipients (N = 153). Factor analysis results supported the 16-item KT-SMS as multidimensional with five domains (medication adherence, cardiovascular risk reduction, protecting kidney, ownership, and skin cancer prevention). Internal consistency reliability for the total scale and five subscales was adequate. Convergent validity was supported as the intercorrelations of the KT-SMS total score with the five subscales were significant. The KT-SMS total score and five subscales were significantly correlated with self-efficacy for managing chronic disease, patient activation, and health-related quality of life. [ABSTRACT FROM AUTHOR]

Lewy body disease (LBD) is a devastating condition with cognitive and physical deficits that pose a challenge to family caregivers. The purpose of this study was to identify the needs and concerns of family caregivers of persons with LBD. A convenience sample of LBD caregivers were interviewed regarding their caregiving needs, concerns, strategies, and advice. A content analysis approach was used to organize data into themes from an existing needs and concerns framework. Findings included the need for more information about the disease, strategies for managing LBD-related emotions and behaviors, support and assistance with physical and instrumental care, and strategies for managing one's own personal responses to caregiving. Findings highlight the need for a Lewy body specific caregiver assessment tool and future caregiver interventions. [ABSTRACT FROM AUTHOR]

Stroke family caregivers often neglect their own health while providing care. Rigorous reviews have focused on stroke caregiver needs and outcomes; however, a comprehensive review of stroke caregiver health is lacking. The purpose of this integrative review was to determine factors associated with stroke family caregiver health. Using a PRISMA flow diagram and Rayyan software, 41 studies were identified published from January 2000 to December 2020. Databases included Cochrane Reviews, Cochrane Trials, PsycINFO, Ovid MEDLINE, PubMed, EBSCOhost MEDLINE, Embase, and CINAHL. Rigorous guidelines were used to critique the 41 articles. Health measures were global in nature, lacking details regarding health promotion activities important to stroke family caregiver health. Common factors associated with caregiver health were depressive symptoms and burden. Further research is needed to design more situation-specific instruments to measure stroke family caregiver health, as well as interventions to reduce depressive symptoms and burden while promoting caregiver health. [ABSTRACT FROM AUTHOR]

Purpose: A strong interpersonal relationship after stroke is important for the prevention of depression in survivors and family caregivers. This study aimed to test the feasibility of quality of relationship intervention for stroke dyads called Hand in Hand (HiH). Methods: Sixteen dyads were randomized into either the HiH group (n = 8) or information, support, and referral (ISR) control group (n = 8). HiH dyads received up to eight sessions, with topics prioritized according to a 17-item screening tool. ISR dyads received up to eight sessions that included information, active listening, and referrals. Feasibility, acceptability, and outcomes data were collected for both groups. Results: The HiH and ISR groups were feasible and acceptable. Caregivers in both groups, as well as survivors in the ISR group, experienced improvements in depressive symptoms and other select outcomes. Conclusions: Findings suggest that HiH is feasible to implement with stroke dyads and that it merits further refinement and testing. [ABSTRACT FROM AUTHOR]

We aimed to compare salient characteristics and antecedents of quality of life (QOL) in adolescents and young adults with implantable cardioverter–defibrillators (ICDs) from qualitative methods with quantitative measurement of QOL and correlations between QOL (PedsQL) and measured participant characteristics. Concurrent parallel mixed methods design was used to collect survey data from the PedsQL electronic health record, demographic questionnaire, and semistructured interview data. A convenience sample of 16 individuals with ICDs, aged 13 to 25 years, was obtained from a tertiary pediatric facility. Overall QOL and subdomains of physical, psychosocial, and academic/work were examined by PedsQL and visual analog scale. Select demographics were collected to develop a participant profile. Females with ICDs appear to be at risk of poor QOL given some unknown factors. Financial status of the individual and the family was positively related to QOL. For new ICD persons involved in physical activities that must be stopped, peer support appears to improve QOL. [ABSTRACT FROM AUTHOR]

This web-based study recruited kidney transplant recipients from Facebook using three recruiting methods over a 5-week period. Participants completed 125 survey items via REDCap (Research Electronic Data Capture) survey. Facebook recruitment generated 153 eligible participants who completed surveys. The average survey response time was 15.07 min (SD = 6.12; range: 4-43), with a low missing item rate (<5%). Facebook's standard ads were most effective for recruiting subjects (n = 78, 51%), followed by three targeted Facebook kidney transplant support groups (n = 52, 34%) and a pay-to-promote study page (n = 12, 7.8%). The average cost paid for each valid survey was US$2.19 through standard Facebook ads and US$2.92 from the study page. The cost for online survey completion is economically feasible even for those with limited funds. Issues related to online surveys including extreme survey response times and participant misrepresentation were reported in this study. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to develop and psychometrically test the Diabetes Caregiver Activity and Support Scale (D-CASS), a measure of how difficult or easy caregiver activity and supportive behaviors are for family caregivers of persons with type 2 diabetes (T2DM). Methods Internal consistency reliability, test-retest reliability, criterion-related validity, and construct validity were examined in 101 family caregivers of persons with T2DM. Participants were recruited using study brochures distributed at a large hospital in the Midwest and at statewide American Indian Pow Wows. Additionally, study brochures were available via a link on Facebook. Data collection occurred by telephone, face-to-face, or through Facebook using measures with evidence of reliability and validity. Family caregivers were predominately female (82.2%), spouses (50.2%), and American Indian (17%), African American (24%), or white (55%). Data were analyzed using descriptive statistics and psychometric analyses. Results The psychometric analyses resulted in an 11-item D-CASS with evidence of internal consistency reliability (alpha = .82) and test-retest reliability. Evidence of construct validity was obtained using 3 hierarchical multiple regressions guided by a conceptual model. Factor analysis supported the unidimensionality of the D-CASS. Conclusion The 11-item D-CASS is a brief and easy to administer instrument that has evidence of reliability and validity in family caregivers of persons with T2DM. [ABSTRACT FROM AUTHOR]

An editorial is presented on family caregiving becoming recognized worldwide as a major social and economic policy issue. Topics include designing tools and protocols for caregiver assessment and implementing, maintaining, and evaluating caregiver support programs within clinical and community settings; and providing a clinically useful description of family caregiver preferences and contributions relating to patient care in the intensive care unit.

Objective: To compare treatment fidelity among treatment arms in the Telephone Assessment and Skill-Building Kit study for stroke caregivers (TASK II) with respect to: 1) protocol adherence; 2) intervention dosage and 3) nurse intervener perspectives. Design: A randomized controlled clinical trial design. Setting: Urban, community, midwestern United States. Subjects: A total of 254 stroke caregivers (mean ±SD age, 54.4 ±11.8 years), 55 (22.0%) males and 199 (78.4%) females) randomized to the TASK II intervention (n=123) or an Information, Support, and Referral comparison group (n=131). Interventions: TASK II participants received the TASK II Resource Guide; Information, Support, and Referral participants received a standard caregiver brochure. At approximately 8 weeks after discharge, both groups received 8 weekly calls from a nurse, with a booster call 4 weeks later. Measures: Protocol adherence was evaluated with the TASK II Checklist for Monitoring Adherence. Intervention dosage was measured by the number of minutes caregivers spent reading materials and talking with the nurse. Nurse intervener perspectives were obtained through focus groups. Results: Protocol adherence was 80% for the TASK II and 92% for the Information, Support, and Referral. As expected, intervention dosage differed between TASK II and Information, Support, and Referral with respect to caregiver time spent reading materials (t=-6.49; P<.001) and talking with the nurse (t=-7.38; P<.001). Focus groups with nurses yielded further evidence for treatment fidelity and recommendations for future trials. Conclusions: These findings substantiate treatment fidelity in both study arms of the TASK II stroke caregiver intervention trial (NIH R01NR010388; ClinicalTrials.govNCT01275495). [ABSTRACT FROM AUTHOR]

Although type 2 diabetes is a chronic illness affecting the entire family, scant literature exists in this area. This study’s purpose was to identify needs of family caregivers of persons with type 2 diabetes across cultures. Using a semi-structured interview guide with open-ended questions, a convenience sample of 33 family caregivers of American Indians (n = 14), African Americans (n = 11), and Caucasians (n = 8) with type 2 diabetes were interviewed by telephone. Qualitative content analysis was conducted based on five pre-determined categories derived from an existing conceptual model. Results were similar across groups and provided support for the conceptual model with themes emerging within the five pre-determined categories: (a) information about type 2 diabetes, (b) managing emotions and behaviors, (c) physical care, (d) instrumental care, and (e) personal responses to caregiving. No additional themes emerged. Although small and exploratory, findings provide information that may be useful to the future development of culturally based interventions. [ABSTRACT FROM AUTHOR]

Purpose The purposes of this review were to identify the needs and concerns of family caregivers of persons with type 2 diabetes and to develop recommendations for future research on family caregivers of American Indians with type 2 diabetes. Searching the Cumulative Index to Nursing and Allied Health, Ovid, and PubMed, an extensive literature review was conducted using 10 search terms for articles published from 1990 to 2013. References of retrieved studies were also searched. Conclusions On the basis of the search criteria, 6 studies exploring the needs and concerns of family caregivers of persons with type 2 diabetes were identified. Findings were placed in 5 predetermined categories derived from Bakas et al's needs and concerns framework; (1) finding information and resources related to type 2 diabetes, (2) dealing with the emotions and behaviors of the care recipient, (3) providing physical care, (4) providing instrumental care, and (5) dealing with one's own personal responses to caregiving. The cross-cultural literature helped identify common ground and specific literature about the experiences of American Indian caregivers. Further research is needed on the needs of caregivers of persons with type 2 diabetes, particularly those in the Native American and other minority populations. Findings can be used to develop interventions to improve outcomes for these caregivers. [ABSTRACT FROM AUTHOR]

This study estimates the prevalence of depressed mood in caregivers of individuals with mild cognitive impairment (MCI) and assesses whether demographics, stressors, intrapsychic strain, and gain are associated with depressed mood. A secondary, analysis of baseline data from the Alzheimer's Disease Cooperative Study MCI trial was conducted using a cross-sectional, correlational design. Descriptive statistics to estimate the prevalence of caregiver depressed mood and univariate and blockwise logistic regression analyses were used. The prevalence of depressed mood in 769 caregivers was 24.6% (95% confidence interval, 21.5-27.7). The odds of being depressed were significantly higher in younger, nonspousal caregivers with less education, who cared for MCI patients with lower activities of daily living functioning, and who perceived greater relational deprivation, higher levels of self-loss, and personal gain. Controlling for relevant variables, relational deprivation and caregiver education continued to be significantly associated with depressed mood. Relational deprivation may he important for future interventions. [ABSTRACT FROM AUTHOR]